SearchGeorgia1041C0700X

Lisa Mustillo

NPI 1912181132 · on the registry since 2007 · sole proprietor

Practice

Address
180 Montgomery St Ne
Marietta, GA 30060
Phone
(917) 992-7896

Additional practice sites

  • 1841 Broadway @ 60th Street, New York, NY

Registry record

Primary taxonomy
1041C0700X
1041C0700X
Also registered as
1041C0700X
Licence states on file
NY, GA
From the registry's licence fields, which are often incomplete.
Sex
Female
Record last updated
2021-06-07

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Georgia